| NPI | 1427679109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ R80798) |
| Additional Taxonomies | 208D00000X General Practice (Licence: ID M-15994) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2024-07-01 |